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Diagnostic validity across racial and ethnic groups in the assessment of adolescent DSM‐IV disorders
Authors:Jennifer Greif Green  Michael J. Gruber  Ronald C. Kessler  Julia Y. Lin  Katie A. Mclaughlin  Nancy A. Sampson  Alan M. Zaslavsky  Margarita Alegria
Affiliation:1. School of Education, Boston University, , Boston, MA, USA;2. Department of Health Care Policy, Harvard Medical School, , Boston, MA, USA;3. (+1) 617‐432‐3587(+1) 617‐432‐3588;4. Cooperative Studies Program Coordinating Center, VA Palo Alto Healthcare System, , Mountain View, CA, USA;5. Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, , Boston, MA, USA;6. Center for Multicultural Mental Health Research, Cambridge Health Alliance, , Somerville, MA, USA
Abstract:We examine differential validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) diagnoses assessed by the fully‐structured Composite International Diagnostic Interview Version 3.0 (CIDI) among Latino, non‐Latino Black, and non‐Latino White adolescents in comparison to gold standard diagnoses derived from the Schedule for Affective Disorders and Schizophrenia for School‐age Children (K‐SADS). Results are based on the National Comorbidity Survey Replication Adolescent Supplement, a national US survey of adolescent mental health. Clinicians re‐interviewed 347 adolescent/parent dyads with the K‐SADS. Sensitivity and/or specificity of CIDI diagnoses varied significantly by ethnicity/race for four of ten disorders. Modifications to algorithms sometimes reduced bias in prevalence estimates, but at the cost of reducing individual‐level concordance. These findings document the importance of assessing fully‐structured diagnostic instruments for differential accuracy in ethnic/racial subgroups. Copyright © 2012 John Wiley & Sons, Ltd.
Keywords:National Comorbidity Survey Replication Adolescent Supplement  validity  disparities
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